Electrosurgical cutting and sealing instrument

ABSTRACT

A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to supply energy from a power source to captured tissue. The surgical instrument comprises a tissue-cutting element to transect the captured tissue. The rate of distal translation of the tissue-cutting element during the operational stroke may be regulated by a linear actuator, for example.

BACKGROUND

The present invention relates to medical devices and methods. Moreparticularly, the present invention relates to electrosurgicalinstruments and methods for sealing and transecting tissue.

In various circumstances, a surgical instrument can be configured toapply energy to tissue in order to treat and/or destroy the tissue. Incertain circumstances, a surgical instrument can comprise one or moreelectrodes which can be positioned against and/or positioned relative tothe tissue such that electrical current can flow from one electrode,through the tissue, and to the other electrode. The surgical instrumentcan comprise an electrical input, a supply conductor electricallycoupled with the electrodes, and/or a return conductor which can beconfigured to allow current to flow from the electrical input, throughthe supply conductor, through the electrodes and the tissue, and thenthrough the return conductor to an electrical output, for example. Invarious circumstances, heat can be generated by the current flowingthrough the tissue, wherein the heat can cause one or more hemostaticseals to form within the tissue and/or between tissues. Such embodimentsmay be particularly useful for sealing blood vessels, for example. Thesurgical instrument can also comprise a cutting element that can bemoved relative to the tissue and the electrodes in order to transect thetissue.

By way of example, energy applied by a surgical instrument may be in theform of radio frequency (“RF”) energy. RF energy is a form of electricalenergy that may be in the frequency range of 300 kilohertz (kHz) to 1megahertz (MHz). In application, RF surgical instruments transmit lowfrequency radio waves through electrodes, which cause ionic agitation,or friction, increasing the temperature of the tissue. Since a sharpboundary is created between the affected tissue and that surrounding it,surgeons can operate with a high level of precision and control, withoutmuch sacrifice to the adjacent normal tissue. The low operatingtemperatures of RF energy enables surgeons to remove, shrink or sculptsoft tissue while simultaneously sealing blood vessels. RF energy worksparticularly well on connective tissue, which is primarily comprised ofcollagen and shrinks when contacted by heat.

In various open, endoscopic, and/or laparoscopic surgeries, for example,it may be necessary to coagulate, seal, and/or fuse tissue. One means ofsealing tissue relies upon the application of electrical energy totissue captured within an end effector of a surgical instrument in orderto cause thermal effects within the tissue. Various mono-polar andbi-polar radio frequency (RF) surgical instruments and surgicaltechniques have been developed for such purposes. In general, thedelivery of RF energy to the captured tissue elevates the temperature ofthe tissue and, as a result, the energy can at least partially denatureproteins within the tissue. Such proteins, such as collagen, forexample, may be denatured into a proteinaceous amalgam that intermixesand fuses, or “welds”, together as the proteins renature. As the treatedregion heals over time, this biological “weld” may be reabsorbed by thebody's wound healing process.

In certain arrangements of a bi-polar radio frequency (RF) surgicalinstrument, the surgical instrument can comprise opposing first andsecond jaws, wherein the face of each jaw can comprise an electrode. Inuse, the tissue can be captured between the jaw faces such thatelectrical current can flow between the electrodes in the opposing jawsand through the tissue positioned therebetween. Such instruments mayhave to seal or “weld” many types of tissues, such as anatomicstructures having walls with irregular or thick fibrous content, bundlesof disparate anatomic structures, substantially thick anatomicstructures, and/or tissues with thick fascia layers such as largediameter blood vessels, for example. With particular regard to sealinglarge diameter blood vessels, for example, such applications may requirea high strength tissue weld immediately post-treatment.

The foregoing discussion is intended only to illustrate various aspectsof the related art in the field of the invention at the time, and shouldnot be taken as a disavowal of claim scope.

SUMMARY

In one embodiment, an electrosurgical instrument may comprise a handle,an elongate shaft extending distally from the handle, where the elongateshaft defines a longitudinal axis, and a trigger coupled to the elongateshaft. The electrosurgical instrument may also comprise an end effectorcoupled to the distal end of the elongate shaft that comprises a firstjaw member and a second jaw member. The first jaw member may be movablerelative to the second jaw member between an open and a closed position.The electrosurgical instrument may also comprise an axially movablemember configured to open and close the jaws and a tissue-cuttingelement positioned at a distal end of the axially movable memberconfigured to translate with respect to the first jaw and the secondjaw, and an electrode. The electrosurgical instrument may also comprisea spring operably coupled to the trigger, the spring to release energyand distally translate the axially movable member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, where theelongate shaft defines a longitudinal axis, and a trigger coupled to theelongate shaft. The electrosurgical instrument may further comprise aninternal shaft, where the internal shaft defines a longitudinal axisthat is substantially perpendicular to the longitudinal axis of theelongate shaft, and an end effector coupled to the distal end of theelongate shaft. The end effector may comprise a first jaw member and asecond jaw member, where the first jaw member is movable relative to thesecond jaw member between an open and a closed position, an electrode,and a tissue-cutting element configured to translate with respect to thefirst jaw and the second jaw. The electrosurgical instrument may furthercomprise an axially moveable member configured to open and close thejaws. The tissue-cutting element may be positioned at a distal end ofthe axially movable member. The electrosurgical instrument may furthercomprise a spring operably connected to the trigger to regulate thedistal translation the moveable cutting member.

In yet another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablemember configured to open and close the jaws with the tissue-cuttingelement be positioned at a distal end of the axially movable member anda trigger coupled to the moveable cutting member. The electrosurgicalinstrument may further comprise an advance biasing member operablyconnected to the trigger and the moveable cutting member, and a returnbiasing member operably connected to the moveable cutting member and thehandle.

In one embodiment, an electrosurgical instrument may comprise a handle,an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws and a triggercoupled to the axially moveable cutting member. The tissue-cuttingelement may be positioned at a distal end of the axially movable member.The electrosurgical instrument may further comprise a linear actuatorcoupled to the axially moveable cutting member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws, where the moveablecutting member comprises a distal stop and a proximate stop, and atrigger coupled to the axially moveable cutting member movable between afirst position, a second position, and a third position. Thetissue-cutting element may be positioned at a distal end of the axiallymovable member. The electrosurgical instrument may further comprise alinear actuator coupled to a nut, where the nut is coupled to theaxially moveable cutting member intermediate the distal stop and theproximate stop.

In yet another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws and a triggercoupled to the axially moveable cutting member, where the trigger ismovable between a first position and a second position. Thetissue-cutting element may be positioned at a distal end of the axiallymovable member. The electrosurgical instrument may further comprise alinear actuator coupled to the axially moveable cutting member and aload cell coupled to the axially moveable cutting member, where the loadcell is configured to output a load signal, and where the linearactuator distally drives the axially moveable cutting member at avariable speed, where the variable speed is at least partially based onthe load signal.

In one embodiment, an electrosurgical instrument may comprise a handle,an elongate shaft extending distally from the handle, a trigger moveablebetween a first position and a second position, and an end effectorcoupled to the distal end of the elongate shaft. The end effector maycomprise a first jaw member and a second jaw member, where the first jawmember is movable relative to the second jaw member between an open anda closed position. The end effector may also comprise a tissue-cuttingelement configured to translate with respect to the first jaw and thesecond jaw, and an electrode. The electrosurgical instrument may furthercomprise an axially moveable cutting member configured to open and closethe jaws, and a damper coupled to the trigger and the axially moveablecutting member. The tissue-cutting element may be positioned at a distalend of the axially movable member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws and a triggermoveable between a first position and a second position, where thetrigger is coupled to the axially moveable cutting member. Thetissue-cutting element may be positioned at a distal end of the axiallymovable member. The electrosurgical instrument may further comprise adamper positioned in the handle, where the damper is positioned toengage the trigger and oppose movement of the trigger from the firstposition to the second position.

In yet another embodiment, an electrosurgical instrument may a handle,an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member, a second jaw member, where thefirst jaw member is movable relative to the second jaw member between anopen and a closed position. The end effector may also comprise atissue-cutting element configured to translate with respect to the firstjaw and the second jaw, and an electrode. The electrosurgical instrumentmay further comprise an axially moveable cutting member configured toopen and close the jaws, a trigger moveable between a first position anda second position, and a damper, where the damper comprises a barrel anda plunger, where the plunger is coupled to the axially moveable cuttingmember and the trigger. The tissue-cutting element may be positioned ata distal end of the axially movable member.

In one embodiment, an electrosurgical instrument may comprise a handle,an elongate shaft extending distally from the handle, a trigger moveablebetween a first position and a second position, an electromagneticbrake, and an end effector coupled to the distal end of the elongateshaft. The end effector may comprise a first jaw member, a second jawmember, where the first jaw member is movable relative to the second jawmember between an open and a closed position, and a tissue-cuttingelement configured to translate with respect to the first jaw and thesecond jaw. The end effector may also comprise an axially moveablecutting member configured to open and close the jaws, and an electrode.The tissue-cutting element may be positioned at a distal end of theaxially movable member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, a triggermoveable between a first position and a second position, and anelectrically activated brake comprising an engaging portion. Theengaging portion may be configured to move from a non-engaged positionto an engaged position. The electrosurgical instrument may furthercomprise a controller and an end effector coupled to the distal end ofthe elongate shaft. The end effector may comprise a first jaw member, asecond jaw member, where the first jaw member is movable relative to thesecond jaw member between an open and a closed position, atissue-cutting element configured to translate with respect to the firstjaw and the second jaw, and a sensor in electrical communication withthe controller. The electrosurgical instrument may further comprise anaxially moveable cutting member configured to open and close the jaws.The tissue-cutting element may be positioned at a distal end of theaxially movable member.

In yet another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, a triggercomprising a rotor moveable between a first position and a secondposition, and an electromagnetic brake configured to selectively engagethe rotor. The electrosurgical instrument may further comprise an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw, and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws. The tissue-cuttingelement may be positioned at a distal end of the axially movable member.

In one embodiment, an electrosurgical instrument may comprise a handle,an elongate shaft extending distally from the handle, a trigger, and anend effector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw, and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws, an electromagnetpositioned proximate to the trigger, and an electromagnet engagingsurface positioned proximate to the trigger. The tissue-cutting elementmay be positioned at a distal end of the axially movable member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, a triggermovable between a plurality of positions, and an end effector coupled tothe distal end of the elongate shaft. The end effector may comprise afirst jaw member and a second jaw member, where the first jaw member ismovable relative to the second jaw member between an open and a closedposition. The end effector may also comprise a tissue-cutting elementconfigured to translate with respect to the first jaw and the secondjaw, and an electrode. The electrosurgical instrument may furthercomprise an axially moveable cutting member configured to open and closethe jaws and a plurality of electromagnetic gates. The tissue-cuttingelement may be positioned at a distal end of the axially movable member.

In yet another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, a triggermovable between a plurality of positions during a trigger stroke, and afirst electromagnetic gate and a second electromagnetic gate. The firstelectromagnetic gate and a second electromagnetic gate may each bepositioned to sequentially pass proximate to an electromagnet engagingsurface during the trigger stroke. The electrosurgical instrument mayfurther comprise an end effector coupled to the distal end of theelongate shaft that comprises a first jaw member and a second jawmember, where the first jaw member is movable relative to the second jawmember between an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw and an electrode. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to close the jaws during the trigger stroke.The tissue-cutting element may be positioned at a distal end of theaxially movable member.

In one embodiment, an electrosurgical instrument may comprise a handlewith an indicator configured to provide a serial series of feedbacksignals during an operational stroke and an elongate shaft extendingdistally from the handle. The electrosurgical instrument may furthercomprise an end effector coupled to the distal end of the elongateshaft. The end effector may comprise a first jaw member and a second jawmember, where the first jaw member is movable relative to the second jawmember between an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw, an electrode, and a sensor. Theelectrosurgical instrument may further comprise an axially moveablecutting member configured to open and close the jaws and a triggercoupled to the axially moveable cutting member. The tissue-cuttingelement may be positioned at a distal end of the axially movable member.

In another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and anindicator configured to provide a sequence of feedback signals duringthe operational stroke. The electrosurgical instrument may furthercomprise an end effector coupled to the distal end of the elongateshaft. The end effector may comprise a first jaw member and a second jawmember, where the first jaw member is movable relative to the second jawmember between an open and a closed position. The end effector may alsocomprise a tissue-cutting element configured to translate with respectto the first jaw and the second jaw, an electrode, and an impedancesensor. The electrosurgical instrument may further comprise an axiallymoveable cutting member configured to close the jaws during theoperational stroke and a ratcheting trigger coupled to the axiallymoveable cutting member, where the ratcheting trigger is movable betweena plurality of discrete positions during an operational stroke. Thetissue-cutting element may be positioned at a distal end of the axiallymovable member.

In yet another embodiment, an electrosurgical instrument may comprise ahandle, an elongate shaft extending distally from the handle, and an endeffector coupled to the distal end of the elongate shaft. The endeffector may comprise a first jaw member and a second jaw member, wherethe first jaw member is movable relative to the second jaw memberbetween an open and a closed position to clamp tissue in the closedposition. The end effector may also comprise a tissue-cutting elementconfigured to translate with respect to the first jaw and the second jawand an electrode. The electrosurgical instrument may further comprise anaxially moveable member configured to distally translate during theoperational stroke to close the jaws and a ratcheting trigger coupled tothe axially moveable cutting member, where the ratcheting trigger ismovable between a plurality of discrete positions during an operationalstroke. The tissue-cutting element may be positioned at a distal end ofthe axially movable member. The electrosurgical instrument may furthercomprise an indicator configured to verify an independence level in asection of the clamped tissue during the operational stroke.

The foregoing discussion should not be taken as a disavowal of claimscope.

FIGURES

Various features of the embodiments described herein are set forth withparticularity in the appended claims. The various embodiments, however,both as to organization and methods of operation, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a perspective view of a surgical instrument according to anon-limiting embodiment.

FIG. 2 is a side view of a handle of the surgical instrument of FIG. 1with a half of a handle body removed to illustrate some of thecomponents therein.

FIG. 3 is a perspective view of an end effector of the surgicalinstrument of FIG. 1 illustrated in an open configuration; the distalend of an axially moveable member is illustrated in a retractedposition.

FIG. 4 is a perspective view of the end effector of the surgicalinstrument of FIG. 1 illustrated in a closed configuration; the distalend of the axially moveable member is illustrated in a partiallyadvanced position.

FIG. 5 is a perspective sectional view of a portion of an axiallymoveable member of the surgical instrument of FIG. 1; the axiallymoveable member is shown at least partially shaped like an I-beam.

FIG. 6 is a sectional view of the end effector of FIG. 1

FIG. 7 is a schematic representation of an actuation assembly inaccordance with one non-limiting embodiment.

FIG. 8 a cross-sectional view of the engagement between the internalshaft of FIG. 7 and the moveable locking member in accordance with onenon-limiting embodiment.

FIG. 9 is a schematic representation of an actuation assembly inaccordance with one non-limiting embodiment.

FIG. 10 is a simplified representation of an actuation assembly inaccordance with one non-limiting embodiment.

FIG. 10A is a close-up view of the damper of FIG. 10 in accordance withone non-limiting embodiment.

FIG. 11 is a simplified representation of an actuation assembly inaccordance with one non-limiting embodiment.

FIGS. 12-15 illustrate a representation of an electrosurgical instrumentcomprising a linear actuator in accordance with one non-limitingembodiment.

FIG. 16 is a block diagram of a control system of an electrosurgicalinstrument in accordance with one non-limiting embodiment.

FIG. 17 is a flow chart of the operation of an electrosurgicalinstrument having a linear actuator in accordance with one non-limitingembodiment.

FIGS. 18-21 illustrate an electrosurgical instrument having a damper inaccordance with one non-limiting embodiment.

FIG. 18A is an enlarged cross-sectional view of the damper in FIGS.18-21.

FIGS. 22-25 illustrate an electrosurgical instrument with a damperhaving two check valves

FIG. 22A is an enlarged cross-sectional view of the damper in FIGS.22-25.

FIG. 26 illustrates a damper that is coupled to a tab of a trigger inaccordance with one non-limiting embodiment.

FIG. 26A is an enlarged view of the damper in FIG. 26.

FIG. 27 illustrates a rotary damper in accordance with one non-limitingembodiment.

FIG. 27A is a cross-sectional view of the damper in FIG. 27 taken alongline 27A-27A.

FIG. 28 illustrates an electrosurgical instrument incorporating anelectromagnetic brake assembly in accordance with one non-limitingembodiment.

FIG. 29 illustrates an electromagnetic brake assembly in accordance withone non-limiting embodiment.

FIG. 30 illustrates an electromagnetic brake assembly in accordance withone non-limiting embodiment.

FIG. 31 is a partial cut-away view of an electrosurgical instrumenthaving an electromagnetic brake assembly in accordance with onenon-limiting embodiment.

FIG. 32 illustrates an enlarged view of a brake pad in accordance withone non-limiting embodiment.

FIGS. 33A and 33B, illustrate the electromagnetic brake assembly in FIG.31 in various stages of operation.

FIG. 34 is a partial cut-away view of an electrosurgical instrumenthaving an electromagnetic brake assembly in accordance with onenon-limiting embodiment.

FIG. 35 illustrates an electrosurgical instrument having electromagneticgates to regulate the operational stroke in accordance with onenon-limiting embodiment.

FIGS. 36A, 36B, and 36C are enlarged side views of the trigger web andthe electromagnet engaging surface in FIG. 35 during an operationalstroke in accordance with one non-limiting embodiment.

FIG. 37 is a partial cut-away view of an electrosurgical instrumenthaving a feedback indicator in accordance with one non-limitingembodiment.

FIGS. 38A, 38B, 38C, and 38D illustrate the progression of feedbacksignals provided by the feedback indicator in FIG. 37 in accordance withone non-limiting embodiment.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Various embodiments are directed to apparatuses, systems, and methodsfor the treatment of tissue. Numerous specific details are set forth toprovide a thorough understanding of the overall structure, function,manufacture, and use of the embodiments as described in thespecification and illustrated in the accompanying drawings. It will beunderstood by those skilled in the art, however, that the embodimentsmay be practiced without such specific details. In other instances,well-known operations, components, and elements have not been describedin detail so as not to obscure the embodiments described in thespecification. Those of ordinary skill in the art will understand thatthe embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment,” or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation.

The entire disclosures of the following non-provisional United Statespatents are hereby incorporated by reference herein:

U.S. Pat. No. 7,381,209, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,354,440, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,311,709, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,309,849, entitled POLYMER COMPOSITIONS EXHIBITING A PTCPROPERTY AND METHODS OF FABRICATION;

U.S. Pat. No. 7,220,951, entitled SURGICAL SEALING SURFACES AND METHODSOF USE;

U.S. Pat. No. 7,189,233, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,186,253, entitled ELECTROSURGICAL JAW STRUCTURE FORCONTROLLED ENERGY DELIVERY;

U.S. Pat. No. 7,169,146, entitled ELECTROSURGICAL PROBE AND METHOD OFUSE;

U.S. Pat. No. 7,125,409, entitled ELECTROSURGICAL WORKING END FORCONTROLLED ENERGY DELIVERY; and

U.S. Pat. No. 7,112,201, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE.

Various embodiments of systems and methods of the invention relate tocreating thermal “welds” or “fusion” within native tissue volumes. Thealternative terms of tissue “welding” and tissue “fusion” may be usedinterchangeably herein to describe thermal treatments of a targetedtissue volume that result in a substantially uniform fused-togethertissue mass, for example, in welding blood vessels that exhibitsubstantial burst strength immediately post-treatment. The strength ofsuch welds is particularly useful for (i) permanently sealing bloodvessels in vessel transection procedures; (ii) welding organ margins inresection procedures; (iii) welding other anatomic ducts whereinpermanent closure is required; and also (iv) for performing vesselanastomosis, vessel closure or other procedures that join togetheranatomic structures or portions thereof. The welding or fusion of tissueas disclosed herein is to be distinguished from “coagulation”,“hemostasis” and other similar descriptive terms that generally relateto the collapse and occlusion of blood flow within small blood vesselsor vascularized tissue. For example, any surface application of thermalenergy can cause coagulation or hemostasis—but does not fall into thecategory of “welding” as the term is used herein. Such surfacecoagulation does not create a weld that provides any substantialstrength in the treated tissue.

At the molecular level, the phenomena of truly “welding” tissue asdisclosed herein may result from the thermally-induced denaturation ofcollagen and other protein molecules in a targeted tissue volume tocreate a transient liquid or gel-like proteinaceous amalgam. A selectedenergy density is provided in the targeted tissue to cause hydrothermalbreakdown of intra- and intermolecular hydrogen crosslinks in collagenand other proteins. The denatured amalgam is maintained at a selectedlevel of hydration—without desiccation—for a selected time intervalwhich can be very brief. The targeted tissue volume is maintained undera selected very high level of mechanical compression to insure that theunwound strands of the denatured proteins are in close proximity toallow their intertwining and entanglement. Upon thermal relaxation, theintermixed amalgam results in protein entanglement as re-crosslinking orrenaturation occurs to thereby cause a uniform fused-together mass.

It will be appreciated that the terms “proximal” and “distal” may beused throughout the specification with reference to a clinicianmanipulating one end of an instrument used to treat a patient. The term“proximal” refers to the portion of the instrument closest to theclinician and the term “distal” refers to the portion located furthestfrom the clinician. It will be further appreciated that for concisenessand clarity, spatial terms such as “vertical,” “horizontal,” “up,” and“down” may be used herein with respect to the illustrated embodiments.However, surgical instruments may be used in many orientations andpositions, and these terms are not intended to be limiting and absolute.

Various embodiments disclosed herein provide electrosurgical jawstructures adapted for transecting captured tissue between the jaws andfor contemporaneously welding the captured tissue margins withcontrolled application of RF energy. The jaw structures may comprise ascoring element which may cut or score tissue independently of thetissue capturing and welding functions of the jaw structures. The jawstructures may comprise first and second opposing jaws that carrypositive temperature coefficient (PTC) bodies for modulating RF energydelivery to the engaged tissue.

A surgical instrument can be configured to supply energy, such aselectrical energy and/or heat energy, to the tissue of a patient. Forexample, various embodiments disclosed herein provide electrosurgicaljaw structures adapted for transecting captured tissue between the jawsand for contemporaneously welding the captured tissue margins withcontrolled application of RF energy. In some embodiments, theelectrosurgical jaw structures may be adapted to coagulate the capturedtissue rather than weld the captured tissue. All such arrangements andimplementations are intended to be within the scope of this disclosure.

Referring now to FIG. 1, an electrosurgical system 100 is shown inaccordance with various embodiments. The electrosurgical system 100includes an electrosurgical instrument 101 that may comprise a proximalhandle 105, a distal working end or end effector 110 and an introduceror elongate shaft 108 disposed in-between. The end effector 110 maycomprise a set of openable-closeable jaws with straight or curvedjaws—an upper first jaw 120A and a lower second jaw 120B. The first jaw120A and the second jaw 120B may each comprise an elongate slot orchannel 142A and 142B (see FIG. 3), respectively, disposed outwardlyalong their respective middle portions.

The electrosurgical system 100 can be configured to supply energy, suchas electrical energy, ultrasonic energy, and/or heat energy, forexample, to the tissue of a patient. In one embodiment, theelectrosurgical system 100 includes a generator 145 in electricalcommunication with the electrosurgical instrument 101. The generator 145is connected to electrosurgical instrument 101 via a suitabletransmission medium such as a cable 152. In one embodiment, thegenerator 145 is coupled to a controller, such as a control unit 102,for example. In various embodiments, the control unit 102 may be formedintegrally with the generator 145 or may be provided as a separatecircuit module or device electrically coupled to the generator 145(shown in phantom to illustrate this option). Although in the presentlydisclosed embodiment, the generator 145 is shown separate from theelectrosurgical instrument 101, in one embodiment, the generator 145(and/or the control unit 102) may be formed integrally with theelectrosurgical instrument 101 to form a unitary electrosurgical system100.

The generator 145 may comprise an input device 147 located on a frontpanel of the generator 145 console. The input device 147 may compriseany suitable device that generates signals suitable for programming theoperation of the generator 145, such as a keyboard, or input port, forexample. In one embodiment, various electrodes in the first jaw 120A andthe second jaw 120B may be coupled to the generator 145. A cable 152 maycomprise multiple electrical conductors for the application ofelectrical energy to positive (+) and negative (−) electrodes of theelectrosurgical instrument 101. The control unit 102 may be used toactivate electrical source 145. In various embodiments, the generator145 may comprise an RF source, an ultrasonic source, a direct currentsource, and/or any other suitable type of electrical energy source, forexample.

In various embodiments, the electrosurgical system 100 may comprise atleast one supply conductor 139 and at least one return conductor 141,wherein current can be supplied to electrosurgical instrument 101 viathe supply conductor 139 and wherein the current can flow back to thegenerator 145 via return conductor 141. In various embodiments, thesupply conductor 139 and the return conductor 141 may comprise insulatedwires and/or any other suitable type of conductor. In certainembodiments, as described below, the supply conductor 139 and the returnconductor 141 may be contained within and/or may comprise the cable 152extending between, or at least partially between, the generator 145 andthe end effector 110 of the electrosurgical instrument 101. In anyevent, the generator 145 can be configured to apply a sufficient voltagedifferential between the supply conductor 139 and the return conductor141 such that sufficient current can be supplied to the end effector110.

Moving now to FIG. 2, a side view of the handle 105 is shown with halfof a first handle body 106A (see FIG. 1) removed to illustrate variouscomponents within second handle body 106B. The handle 105 may comprise alever arm 128 (e.g., a trigger) which may be pulled along a path 129.The lever arm 128 may be coupled to an axially moveable member 140disposed within elongate shaft 108 by a shuttle 146 operably engaged toan extension 127 of lever arm 128. The shuttle 146 may further beconnected to a biasing device, such as a spring 141, which may also beconnected to the second handle body 106B, to bias the shuttle 146 andthus the axially moveable member 140 in a proximal direction, therebyurging the jaws 120A and 120B to an open position as seen in FIG. 1.Also, referring to FIGS. 1 and 2, a locking member 131 (see FIG. 2) maybe moved by a locking switch 130 (see FIG. 1) between a locked position,where the shuttle 146 is substantially prevented from moving distally asillustrated, and an unlocked position, where the shuttle 146 may beallowed to freely move in the distal direction, toward the elongateshaft 108. The handle 105 can be any type of pistol-grip or other typeof handle known in the art that is configured to carry actuator levers,triggers or sliders for actuating the first jaw 120A and the second jaw120B. The elongate shaft 108 may have a cylindrical or rectangularcross-section, for example, and can comprise a thin-wall tubular sleevethat extends from handle 105. The elongate shaft 108 may include a boreextending therethrough for carrying actuator mechanisms, for example,the axially moveable member 140, for actuating the jaws and for carryingelectrical leads for delivery of electrical energy to electrosurgicalcomponents of the end effector 110.

The end effector 110 may be adapted for capturing and transecting tissueand for the contemporaneously welding the captured tissue withcontrolled application of energy (e.g., RF energy). The first jaw 120Aand the second jaw 120B may close to thereby capture or engage tissueabout a longitudinal axis 125 defined by the axially moveable member140. The first jaw 120A and second jaw 120B may also apply compressionto the tissue. In some embodiments, the elongate shaft 108, along withfirst jaw 120A and second jaw 120B, can be rotated a full 360° degrees,as shown by arrow 117 (FIG. 1), relative to handle 105 through, forexample, a rotary triple contact. The first jaw 120A and the second jaw120B can remain openable and/or closeable while rotated.

FIGS. 3 and 4 illustrate perspective views of the end effector 110 inaccordance with one non-limiting embodiment. FIG. 3 shows end theeffector 110 in an open configuration and FIG. 4 shows the end effector110 in a closed configuration. As noted above, the end effector 110 maycomprise the upper first jaw 120A and the lower second jaw 120B.Further, the first jaw 120A and second jaw 120B may each havetissue-gripping elements, such as teeth 143, disposed on the innerportions of first jaw 120A and second jaw 120B. The first jaw 120A maycomprise an upper first jaw body 161A with an upper first outward-facingsurface 162A and an upper first energy delivery surface 175A. The secondjaw 120B may comprise a lower second jaw body 161 B with a lower secondoutward-facing surface 162B and a lower second energy delivery surface175B. The first energy delivery surface 175A and the second energydelivery surface 175B may both extend in a “U” shape about the distalend of the end effector 110.

Referring briefly now to FIG. 5, a portion of the axially moveablemember 140 is shown. The lever arm 128 of the handle 105 (FIG. 2) may beadapted to actuate the axially moveable member 140 which also functionsas a jaw-closing mechanism. For example, the axially moveable member 140may be urged distally as the lever arm 128 is pulled proximally alongthe path 129 via the shuttle 146, as shown in FIG. 2 and discussedabove. The axially moveable member 140 may comprise one or severalpieces, but in any event, may be movable or translatable with respect tothe elongate shaft 108 and/or the jaws 120A, 120B. Also, in at least oneembodiment, the axially moveable member 140 may be made of 17-4precipitation hardened stainless steel. The distal end of axiallymoveable member 140 may comprise a flanged “I”-beam configured to slidewithin the channels 142A and 142B in jaws 120A and 120B. The axiallymoveable member 140 may slide within the channels 142A, 142B to open andclose first jaw 120A and second jaw 120B. The distal end of the axiallymoveable member 140 may also comprise an upper flange or “c”-shapedportion 140A and a lower flange or “c”-shaped portion 140B. The flanges140A and 140B respectively define inner cam surfaces 144A and 144B forengaging outward facing surfaces of first jaw 120A and second jaw 120B.The opening-closing of jaws 120A and 120B can apply very highcompressive forces on tissue using cam mechanisms which may includemovable “I-beam” axially moveable member 140 and the outward facingsurfaces 162A, 162B of jaws 120A, 120B.

More specifically, referring now to FIGS. 3-5, collectively, the innercam surfaces 144A and 144B of the distal end of axially moveable member140 may be adapted to slidably engage the first outward-facing surface162A and the second outward-facing surface 162B of the first jaw 120Aand the second jaw 120B, respectively. The channel 142A within first jaw120A and the channel 142B within the second jaw 120B may be sized andconfigured to accommodate the movement of the axially moveable member140, which may comprise a tissue-cutting element 148, for example,comprising a sharp distal edge. FIG. 4, for example, shows the distalend of the axially moveable member advanced at least partially throughchannels 142A and 142B (FIG. 3). The advancement of the axially moveablemember 140 may close the end effector 110 from the open configurationshown in FIG. 3. In the closed position shown by FIG. 4, the upper firstjaw 120A and lower second jaw 120B define a gap or dimension D betweenthe first energy delivery surface 175A and second energy deliverysurface 175B of first jaw 120A and second jaw 120B, respectively. Invarious embodiments, dimension D can equal from about 0.0005″ to about0.040″, for example, and in some embodiments, between about 0.001″ toabout 0.010″, for example. Also, the edges of the first energy deliverysurface 175A and the second energy delivery surface 175B may be roundedto prevent the dissection of tissue.

FIG. 6 is a sectional view of the end effector 110 in accordance withone non-limiting embodiment. In one embodiment, the engagement, ortissue-contacting, surface 175B of the lower jaw 120B is adapted todeliver energy to tissue, at least in part, through aconductive-resistive matrix, such as a variable resistive positivetemperature coefficient (PTC) body, as discussed in more detail below.At least one of the upper and lower jaws 120A, 120B may carry at leastone electrode 170 configured to deliver the energy from the generator145 to the captured tissue. The engagement, or tissue-contacting,surface 175A of upper jaw 120A may carry a similar conductive-resistivematrix (i.e., a PTC material), or in some embodiments the surface may bea conductive electrode or an insulative layer, for example.Alternatively, the engagement surfaces of the jaws can carry any of theenergy delivery components disclosed in U.S. Pat. No. 6,773,409, filedSep. 19, 2001, entitled SURGICAL SYSTEM FOR APPLYING ULTRASONIC ENERGYTO TISSUE, the entire disclosure of which is incorporated herein byreference.

The first energy delivery surface 175A and the second energy deliverysurface 175B may each be in electrical communication with the generator145. The first energy delivery surface 175A and the second energydelivery surface 175B may be configured to contact tissue and deliverelectrosurgical energy to captured tissue which are adapted to seal orweld the tissue. The control unit 102 regulates the electrical energydelivered by electrical generator 145 which in turn deliverselectrosurgical energy to the first energy delivery surface 175A and thesecond energy delivery surface 175B. The energy delivery may beinitiated by an activation button 124 (FIG. 2) operably engaged with thelever arm 128 and in electrical communication with the generator 145 viacable 152. In one embodiment, the electrosurgical instrument 101 may beenergized by the generator 145 by way of a foot switch 144 (FIG. 1).When actuated, the foot switch 144 triggers the generator 145 to deliverelectrical energy to the end effector 110, for example. The control unit102 may regulate the power generated by the generator 145 duringactivation. Although the foot switch 144 may be suitable in manycircumstances, other suitable types of switches can be used.

As mentioned above, the electrosurgical energy delivered by electricalgenerator 145 and regulated, or otherwise controlled, by the controlunit 102 may comprise radio frequency (RF) energy, or other suitableforms of electrical energy. Further, the opposing first and secondenergy delivery surfaces 175A and 175B may carry variable resistivepositive temperature coefficient (PTC) bodies that are in electricalcommunication with the generator 145 and the control unit 102.Additional details regarding electrosurgical end effectors, jaw closingmechanisms, and electrosurgical energy-delivery surfaces are describedin the following U.S. patents and published patent applications: U.S.Pat. Nos. 7,087,054; 7,083,619; 7,070,597; 7,041,102; 7,011,657;6,929,644; 6,926,716; 6,913,579; 6,905,497; 6,802,843; 6,770,072;6,656,177; 6,533,784; and 6,500,176; and U.S. Pat. App. Pub. Nos.2010/0036370 and 2009/0076506, all of which are incorporated herein intheir entirety by reference and made a part of this specification.

In one embodiment, the generator 145 may be implemented as anelectrosurgery unit (ESU) capable of supplying power sufficient toperform bipolar electrosurgery using radio frequency (RF) energy. In oneembodiment, the ESU can be a bipolar ERBE ICC 350 sold by ERBE USA, Inc.of Marietta, Ga. In some embodiments, such as for bipolar electrosurgeryapplications, a surgical instrument having an active electrode and areturn electrode can be utilized, wherein the active electrode and thereturn electrode can be positioned against, adjacent to and/or inelectrical communication with, the tissue to be treated such thatcurrent can flow from the active electrode, through the positivetemperature coefficient (PTC) bodies and to the return electrode throughthe tissue. Thus, in various embodiments, the electrosurgical system 100may comprise a supply path and a return path, wherein the capturedtissue being treated completes, or closes, the circuit. In oneembodiment, the generator 145 may be a monopolar RF ESU and theelectrosurgical instrument 101 may comprise a monopolar end effector 110in which one or more active electrodes are integrated. For such asystem, the generator 145 may require a return pad in intimate contactwith the patient at a location remote from the operative site and/orother suitable return path. The return pad may be connected via a cableto the generator 145.

During operation of electrosurgical instrument 101, the user generallygrasps tissue, supplies energy to the captured tissue to form a weld ora seal, and then drives a tissue-cutting element 148 at the distal endof the axially moveable member 140 through the captured tissue.According to various embodiments, the translation of the axial movementof the axially moveable member 140 may be paced, or otherwisecontrolled, to aid in driving the axially moveable member 140 at asuitable rate of travel. By controlling the rate of the travel, thelikelihood that the captured tissue has been properly and functionallysealed prior to transection with the cutting element 148 is increased.

FIG. 7 is a schematic representation of an actuation assembly 200 inaccordance with one non-limiting embodiment with some of the componentsthereof omitted for clarity. Additionally various components of theactuation assembly 200 have been expanded or altered in scale forconvenience. The actuation assembly 200 may be used, for example, withinstruments similar to electrosurgical instrument 101 in order toregulate or otherwise control the axial movement of an axially moveablemember 240. The actuation assembly 200 may comprise an axially moveablemember 240 which has at its distal end 242 a tissue-cutting element,such as a sharp distal edge 243, for example. The axially moveablemember 240 may define a longitudinal axis 246. The axially moveablemember 240 may also comprise a rack 244 configured to engage a drivegear 246. The drive gear 246 may be coupled to an internal shaft 248,which may define a longitudinal axis 250. In one embodiment thelongitudinal axis 250 of the internal shaft 248 is substantiallyperpendicular to the longitudinal axis 246 of the axially moveablemember 240. In some embodiments, a trigger gear 252 may also be coupledto the internal shaft 248. A portion of a trigger assembly 227 maycomprise a rack 254 that is configured to engage the trigger gear 252.The actuation assembly 200 may also comprise a moveable locking member256 this is selectably engagable with the internal shaft 248 or othercomponent of the actuation assembly 200. The actuation assembly 200 mayalso comprise a spring, such as torsional spring 251, which distallydrives the axially moveable member 240. One end of the torsional spring251 may be coupled to the internal shaft 248 when the other end thetorsional spring 251 may be attached to a portion of the actuationassembly 200 that remains stationary relative to the rotating internalshaft 248. Rotation of the internal shaft 248 winds the torsional spring251 to generate potential energy which may be selectably transferred tothe internal shaft 248, as described in more detail below.

Referring briefly to FIG. 8, a cross-sectional view of the engagementbetween the internal shaft 248 and the moveable locking member 256 isprovided in accordance with one non-limiting embodiment. The internalshaft 248 may comprise a plurality of facets 258 positioned around itscircumference. The facets 258 may longitudinally span the entireinternal shaft 248, or may be positioned on a portion of the internalshaft 248, such as the portion proximate the moveable locking member256. The movable locking member 256 may comprise a pawl 260 that engagesthe facets 258 of the internal shaft 248. The movable locking member 256may be able to pivot in the direction indicated by arrow 262 to allowthe internal shaft 248 to rotate in a first direction indicated by arrow264. When the pawl 260 is engaged with a facet 258, the internal shaft248 is prohibited from rotating in a second direction indicated by arrow266. When the pawl 260 is disengaged from the facet 248, such as bymovement of the pawl in the direction indicated by arrow 268, theinternal shaft 248 may rotate in the directions indicated by arrow 266and arrow 264.

Referring again to FIG. 7, the operation of the actuation assembly 200allows for a controlled distal translation of the axially moveablemember 240. In accordance with one embodiment, at the beginning of theoperational stroke, the portion of a trigger assembly 227 comprising therack 254 is moved in the direction indicated by arrow 270. As the rack254 translates relative to the trigger gear 252, the trigger gear 252rotates in the direction indicated by arrow 271. As the trigger gear 252rotates, the internal shaft 248 rotates as well, which winds thetorsional spring 251. The drive gear 246 also rotates in the directionindicated by arrow 271, which due to its engagement with the rack 244 ofthe axially moveable member 240, draws the axially moveable member 240in the proximal direction indicated by arrow 272. The moveable lockingmember 256 keeps the internal shaft 248 from rotating in the directionindicated by arrow 274, despite the rotational force of the torsionalspring 251 bearing on the internal shaft 248. When the activation button124 (FIG. 2) is pressed, the movable locking member 256 may withdrawfrom engagement with the internal shaft 248. The coupling of theactivation button 124 to the movable locking member 256 may be madeusing any suitable technique, such as a mechanical linkage, for example.In some embodiments, a tab on the trigger assembly 227 contacts themovable locking member 256 to move it from engagement with the internalshaft 228 once the torsional gear 251 is wound. Accordingly, anysuitable technique may be used to disengage the movable locking member256 from the internal shaft 248.

With the movable locking member 256 no longer locking the internal shaft248, the internal shaft 248 rotates in the direction indicated by arrow274 as the torsional spring 251 unwinds. Consequently, the drive gear246 also rotates, and through its engagement with the rack 244, theaxially moveable member 240 is driven in the distal direction indicatedby arrow 276. The rate of travel of the axially moveable member 240 isgenerally dependent on the spring constant of the torsional spring 251,as opposed to the user's interaction with the trigger.

In various embodiments, the parameters of the components of theactuation assembly 200 may be altered to achieve the desiredperformance. For example, the size or strength of the torsional spring251 may be changed. In one embodiment the gear ratio between the triggergear 252 and the drive gear 246 may be a 1:1 ratio, while in otherembodiments a different ratio is used. In some embodiments, as shown inFIG. 9, a single gear 280 may engage both the rack 254 of the triggerassembly 257 and the rack 244 of the axially moveable member 240. Insome embodiments, a dashpot, such as damper 312 (FIG. 10), may be usedto further control the translation of axially moveable member 240.

FIG. 10 is a simplified representation of an actuation assembly 300 inaccordance with one non-limiting embodiment with some of the componentsthereof omitted for clarity. The actuation assembly 300 is associatedwith a handle 302 and an axially moveable member 306 extending distallyfrom the handle. An end effector similar to the end effector 110illustrated in FIG. 3 may be coupled to the distal end of an elongateshaft 304. The axially moveable member 306 may extend from the endeffector and into the handle 302. As described in more detail below, atrigger 307 is operably coupled to the axially moveable member 306. Invarious embodiments, an advance spring 308 and a return spring 310 areeach operably connected to the axially moveable member 306. The advancespring 308 and the return spring 310 may have different springconstants. In one embodiment, the advance spring 308 has a higher springconstant than the return spring 310. The actuation assembly 300 mayfurther comprise a damper 312 configured to regulate (i.e., slow) thetranslation of the axially moveable member 306.

FIG. 10A provides a close-up view of the damper 312 in accordance withone non-limiting embodiment. The damper 312 comprises a barrel 314 and aplunger 316, wherein an outer surface of the plunger 316 is in sealingengagement with an inner surface of the barrel 314 to create a variablevolume cavity 315. While the damper 312 is illustrated as having abarrel and plunger arrangement, any suitable damping device may be used,such as mechanical or hydraulics dashpots, for example. This disclosureis not limited to any particular damper arrangement. The plunger 316 maybe coupled to, for example, the proximal end of the axially moveablemember 306. The plunger may be movable between a first and secondposition within the barrel 314. The damper 312 may define a first port318 having a first flow path and a second port 320 having a second flowpath. In one embodiment, the damper 312 comprises a check valve 322positioned in the second flow path. During operation, air may flow inboth directions through the first flow path, while air may only exit thevariable volume cavity 315 through the second flow path. As is to beappreciated, the size and number of ports in the barrel 314 may bevaried to achieve the desired dampening.

Referring again to FIG. 10, the trigger 307 may pivot or rotate about apivot 324 such that as the bottom trigger portion 307 a is rotated inthe direction indicated by arrow 326, the top trigger portion 307 b isrotated in the direction indicated by arrow 328. The top trigger portion307 b may be coupled to an end of the advance spring 308. The other endof the advance spring 308 may be coupled to the axially moveable member306, such as via a linkage 324. One end of the return spring 310 mayalso be coupled to the axially moveable member 306, such as via thelinkage 324. The other end of the return spring 310 may be fixed to amount 326. The advance spring 308 and the return spring 310 may exertbiasing forces on the axially moveable member 306 in generally oppositelongitudinal directions.

When the bottom trigger portion 307 a is squeezed by a user, the toptrigger portion 307 b exerts a longitudinal force on both the advancespring 308 and the return spring 310 in the direction indicated by arrow328. As described above, the squeezing of the trigger 307 may close thejaws of an associated end effector to capture tissue. As the usersqueezes the trigger 307, both springs 308, 310 expand, the axiallymoveable member 306 distally translates in order to transect thecaptured tissue. The rate of travel of the axially moveable member 306is regulated as a function of the spring constants of the springs 308,310 and the dampening effects of the damper 312. Referring to FIG. 10A,as the plunger 316 distally translates in the barrel 314, the variablevolume cavity 315 expands and a low pressure, below atmosphere, isgenerated. In order to reach equilibrium, ambient air enters thevariable volume cavity 315 through the first port 318. In theillustrated embodiment, the check valve 322 prohibits air form enteringthe variable volume cavity 315 through the second port 320. As is to beappreciated, the damping coefficient of the damper 312 is a function ofthe rate of the ingress of the air through the first port 318. In someembodiments, the size of the first port 318 may be variable to provide aselectable damping coefficient. As the user continues to squeeze androtate the bottom trigger portion 307 a, the top trigger portion 307 bwill continue to exert a substantially linearly applied force on thesprings 308, 310 which continue to expand. Since the advance spring 308is stronger (i.e., has a higher spring constant) than the return spring310, the axially moveable member 306, via the linkage 324, will be drawndistally in order to transect captured tissue. As the axially moveablemember 306 is translated distally by the force applied through theadvance spring 308, the return spring 310 expands between the linkage324 and the mount 326.

When the user releases the trigger assembly 307, the expanded returnspring 310 exerts a linear force on the linkage 324 to proximallytranslate axially moveable member 306. The proximal translation of theaxially moveable member 306 will drive the plunger 316 (FIG. 10A) intothe barrel 314, thus reducing the size of the variable volume chamber315. Air will be expelled from the variable volume chamber 315 via boththe first portion 318 and the second port 320. Thus, when the plunger316 travels in the proximal direction, the damping coefficient of thedamper 312 is less than when the plunger 316 travels distally.

The advance spring 308 and the return spring 310 may be any suitabletypes of biasing members, such as pistons, coil springs, rubber bands,and/or any other suitable elastic member, for example. In oneembodiment, illustrated in FIG. 11, linear compression springs may beused as biasing members. FIG. 11 is a simplified representation of anactuation assembly 340 in accordance with one alternative non-limitingembodiment with some of the components thereof omitted for clarity. Asillustrated, the actuation assembly 340 may comprise a return spring 342and an advance spring 344. The overall operation of the actuationassembly 340 may be generally similar to the operation of the actuationassembly 300 illustrated in FIG. 10, with the exchange of linearcompression springs for linear expansion springs. Accordingly, as thelower trigger portion 307 a is rotated in the direction indicated byarrow 326, the upper trigger portion 307 b compresses the springs 342,344 similar to the above. The damper 312 serves to regulate the rate ofdistal and proximal translation of the axially moveable member 306.

According to various embodiments, the pacing of the axial movement ofthe axially moveable member may driven by an electric motor or any othertype of suitable linearly actuating device, such as an electroactivepolymer (EAP) actuator, for example. FIGS. 12-15 illustrate arepresentation of an electrosurgical instrument 400 comprising a linearactuator 402 in accordance with one non-limiting embodiment. Forclarity, various components have been omitted. The electrosurgicalinstrument 400 may comprise a proximal handle 405, a distal working endor end effector 410 and an introducer or elongate shaft 408 disposedin-between. An axially moveable member 440 may couple the end effector410 and a trigger assembly 407. The end effector 410 may comprise a setof openable-closeable jaws with straight or curved jaws, similar to theend effector 110 illustrated in FIG. 3, for example. In one embodiment,the linear actuator 402 comprises a lead screw 420 and an electric motor422 coupled to the lead screw 420. The electric motor 422 may be coupledto a power 121 supply 425 via cabling 426. As is to be appreciated, thepower supply 425 may be any suitable power source and may be a separateunit (as illustrated), or carried on-board the electrosurgicalinstrument 400. In some embodiments, other techniques may be used toimpart linear motion to the axially moveable member 440. For example,similar to FIG. 9, the axially moveable member 440 may comprise a rackand the motor 422 may rotate a drive gear operably engaged to the rack.

A nut assembly 424 may be slideably engaged to the axially moveablemember 440 and the lead screw 420. The nut assembly 424 may interfacethe axially moveable member 440 at a clearance 429. The clearance 429may be, for example, a portion of the axially moveable member 440 havinga reduced diameter. Either end of clearance 429 may have a proximal stop428 and a distal stop 430. The proximal and distal stops 428, 430 mayeach be a lip, as illustrated. It is noted that the clearance 429illustrated in FIGS. 12-15 has been expanded for clarity and is notnecessarily drawn to any particular scale. As discussed in more detailbelow, the clearance 429 generally allows for the opening and closing ofthe jaws of the end effector 410, while prohibited the cutting of tissueuntil the tissue has been properly sealed.

The trigger assembly 407 may be operatively engaged with axiallymoveable member 440 at a trigger interface 432. The trigger interface432 may include a distal sensor 434 and a proximal sensor 436. Thetrigger interface 432 may also include a distal trigger stop 433 and aproximal trigger stop 435. The electrosurgical instrument 400 may alsocomprise a button 438. When the button 438 is engaged, electrical energy(i.e., RF energy) may be supplied to captured tissue via the endeffector 410.

With reference to FIGS. 12-15, the operation of the electrosurgicalinstrument 400 in accordance with one non-limiting embodiment will bedescribed. In FIG. 12, the jaws of the end effector 410 are in an openposition allowing tissue to be captured therebetween. A gap 444 ispresent between the nut assembly 424 and the proximal stop 428. In FIG.13, the trigger assembly 407 has been rotated (i.e., squeezed) in thedirection indicated by arrow 446. As the trigger assembly 407 rotates itengages the distal trigger stop 433 which is coupled to the axiallymoveable member 440. As the axially moveable member 440 moves in thedirection indicated by arrow 448, the jaws of the end effector 410 areclosed, similar to the end effector 110 illustrated in FIG. 4. Theprogression of the axially moveable member 440 in the directionindicated by arrow 448 is impeded when the proximal stop 428 engages thenut assembly 424. Accordingly, at this stage in the operational stroke,the distance of travel of axially moveable member 440 is generallylimited to the length of the gap 444 (FIG. 12). In one embodiment, thisdistance is long enough to cause the jaws of the end effector 410 toclamp tissue, while keeping a cutting element at the distal end of theaxially moveable member 440 from contacting the captured tissue.Generally, by providing the clearance 429 on the axially moveable member440, a relatively small amount of trigger assembly manipulation may beperformed by the user to open and close the jaws of the end effectorwithout distally driving the cutting element into the tissue. Thecutting element is only driven through the tissue when the linearactuator 402 is activated. As is to be appreciated, the clearance 429may sized based on the particular arrangement of the electrosurgicalinstrument 400. For example, in one embodiment, the clearance 429 may beless than about 0.5 inches in length as measured between the proximalstop 428 and a distal stop 430. In one embodiment, the clearance 429 maybe less than about 0.2 inches, for example, in length as measuredbetween the proximal stop 428 and a distal stop 430. As is to beappreciated, the size of the clearance 429 for any electrosurgicalinstrument 400 will at least partially depend on the relative size ofthe nut assembly 424 since a gap 444 is required between the nutassembly 424 and the distal stop 430.

Referring now to FIG. 14, when the button 438 is activated by the user,energy flows through electrodes in the end effector 410 to energize thecaptured tissue (not illustrated). When the button 438 is activated andthe trigger 407 is squeezed, the motor 422 of the linear actuator 402rotates lead screw 420 in the direction indicated by arrow 450 (FIG.15). In one embodiment, the motor 422 will only be activated when boththe button 438 is activated to deliver the RF energy to the tissue andthe trigger 407 is squeezed. By requiring the user to complete bothactions before activating the linear actuator 402, the possibility of a“cold cut” (e.g., cutting the tissue before it has been welded) isgreatly reduced or eliminated. The squeezing of the trigger 407 may besensed by the distal sensor 434. The distal sensor 434 may be, forexample, a pressure sensor that supplies a signal to an associatedcontroller. As the lead screw 420 rotates, the nut assembly 424 travelsin the direction indicated by arrow 448, owing to the operativeengagement of threads on the lead screw 420 and a threaded aperture inthe nut assembly 424. As the nut assembly 424 travels along the leadscrew 420, the nut assembly 424 will engage the axially moveable member440 at the distal stop 430. The nut assembly 424 will then push theaxially moveable member 440 in the distal direction as the usercontinues to squeeze the trigger 407 and lead screw 420 continues torotate. A cutting element 452 positioned on the distal end of theaxially moveable member 440 progresses through and transects thecaptured tissue. When the user opens the trigger 407, the trigger 407can move toward and activate the proximal sensor 436. Activation of theproximal sensor 436 will cause the motor 422 to rotate the lead screw420 in the opposite direction, and owing to the threaded engagementbetween the lead screw 420 and the nut assembly 424, the nut assembly424 will translate through the gap 444 (FIG. 12) and engage the axiallymoveable member 440 at the proximal stop 428. The nut assembly 424 willthen push the axially moveable member 440 in the proximal direction asthe user continues to open the trigger 407 and lead screw 420 continuesto rotate. In one embodiment, the motor 422 may rotate the lead screw420 faster during the proximal progression of the axially moveablemember 440 as compared to the distal progression. As is to beappreciated, a controller 502 (FIG. 16) may be used to receive theinputs from various components of the electrosurgical instrument 440,such as the button 438 and the sensors 434, 436, and selectively supplyenergy to the motor 422.

The speed of the motor 422 may be changed based on any particularapplication. In one embodiment, at least one of the proximal sensor 436and the distal sensor 434 measures the amount of force exerted by theuser during the trigger actuation. In one embodiment, the displacementof the trigger is monitored. In any event, as the force exerted by theuser increases (or the displacement of the trigger increases), the speedof the motor 422 is also increased. Therefore, for applicationsinvolving large amounts of captured tissue, for example, the user canselectively increase or decrease the speed of the motor throughmanipulation of the trigger.

The maximum rate of travel of the axially moveable member 440 isdetermined by the linear actuator 402. In various embodiments, the rateof travel of the axially moveable member 440 may be adjustable by theuser. In some embodiments, the electrosurgical instrument 400 maycomprise a force transducer 442. The force transducer 442 may be anytype of load cell suitable to produce a signal indicative of the force.The force transducer 442 may supply information to the controllerindicative to characteristics of the captured tissue. For example,thicker tissue will generally require more time to properly seal andwill provide more resistance to the axially moveable member 440 as itpasses through the tissue. Comparatively, thinner tissue will generallyrequire less time to properly seal and will provide less resistance tothe axially moveable member 440 as it passes through the tissue.Information from the force transducer 442 may be supplied to thecontroller 502 (FIG. 16) and the speed of the motor 422 may be adjustedto compensate for the tissue characteristics. Accordingly, therotational speed of the lead screw 420 may be reduced when cuttingthicker tissue in order to lengthen the amount of time the capturedtissue is exposed to the RF energy. The rotational speed of the leadscrew 420 may be increased when cutting thinner tissue to shorten theamount of time the captured tissue is exposed to the RF energy andreduce the likelihood of charring or excess heating. In any event, theuse of the linear actuator 402 helps to ensure a steady and regulatedtranslation of the axially moveable member through the tissue, even withend effectors having a relatively long jaw length.

In various embodiments, the electrosurgical instrument 440 may have anencoder 460 associated with the linear actuator 402. The encoder 460 maysupply information to an associated controller to aid in the cutting ofthe captured tissue, such as speed data. The encoder 460 may be any typeof suitable encoder, such as a rotary encoder to monitor the rotation ofthe lead screw 420. The linear displacement of the axially moveablemember 440 may then be determined as a function of the threaded couplingbetween the nut assembly 424 to the lead screw 420.

FIG. 16 is a block diagram of a control system 500 of an electrosurgicalinstrument in accordance with one non-limiting embodiment. A controller502 receives various inputs from the components, such as an encoder 560,a force transducer 542, a button 538, a distal sensor 534, and aproximal sensor 536. When an activation signal is received from thebutton 538, the controller 502 may send a signal to an RF source 504which, in turn, provides RF energy to an electrode 506. When thecontroller 502 receives an activation signal from both the button 538and the distal sensor 534, the controller 502 may supply current to themotor 522. As described above, information received from the encoder 560and the force transducer 542 may provide a feedback loop to aid in themotor control. For example, the encoder 560 may indicate that theaxially moveable member has reached the distal end of its strokeindicating to the controller 502 to cease supplying current to the motor522. When the proximal sensor 536 supplies a signal to the controller502, the controller 502 may rotate the motor 522 in an oppositedirection. The encoder 560 may indicate that the axially moveable memberhas reached the proximal of its stroke indicating to the controller 502to cease supplying current to the motor 522.

FIG. 17 is a flow chart 580 of the operation of an electrosurgicalinstrument having a linear actuator in accordance with one non-limitingembodiment. At 582, the instrument is in a standby mode. In standbymode, the jaws are in the open position and ready to engage tissue. At584, a main trigger, such as trigger 407 (FIG. 14) is moved from a firstposition to a second position in order to capture tissue between thejaws. At 586, a button, such as button 538, for example, or any othertype of triggering or activation device, is activated to supplyelectrical energy to the captured tissue. At 588, while the button isactivated, the main trigger is moved from the second position to a thirdposition to activate a linear actuator and cut the captured tissue. At590, an axially moveable member is distally advanced using a linearactuator. At 592, the main trigger is moved from the third position backto the first position and the linear actuator is activated to move theaxially moveable member in the proximal direction to open the jaws ofthe end effector.

In various embodiments, a dashpot may be coupled to a trigger-actuatedaxially moveable member in order to regulate the rate of travel ofaxially moveable member. FIGS. 18-21 illustrate an electrosurgicalinstrument 600 with various components removed, or otherwise simplified,for clarity. The electrosurgical instrument 600 has a handle 602 and anelongate shaft 604 extending distally from the handle. An end effector610 similar to the end effector 110 illustrated in FIG. 3 may be coupledto the distal end of the elongate shaft 604. An axially moveable member606 may extend from the distal end of the elongate shaft 604 into thehandle 602. A trigger 607 is coupled to the axially moveable member 606.The electrosurgical instrument 600 may further comprise a damper 612(shown in cross-section) configured to regulate the translation of theaxially moveable member 606. Generally, movement of the trigger 607corresponds to movement of the axially moveable member 606 in the distaland proximal direction due to a pivot 616 and a linkage 614 connectingthe trigger 607 to the axially moveable member 606.

The damper 612 may be associated with the axially moveable member 606such that it controls the speed of the axially moveable member 606during the operational stroke of the electrosurgical instrument 600.FIG. 18A is an enlarged cross-sectional view of the damper 612 inaccordance with one non-limiting embodiment. In one embodiment, thedamper 612 comprises a barrel 620 and a plunger 622, wherein an outerdiameter of the plunger 622 is in sealing engagement with an innerdiameter of the barrel 620. As is to be appreciated, an o-ring 640, orother type of sealing device may be positioned around the periphery ofthe plunger 622 to aid in creating a seal with the barrel 620.Furthermore, as illustrated, the plunger 622 may be coupled to theaxially moveable member 606. The plunger 622 may be formed unitary withthe axially moveable member 606 or otherwise coupled thereto. The damper612 may also have a spring 624, or other biasing element, to bias theaxially moveable member 606 in the proximal direction. In theillustrated embodiment, a spring 624 is positioned intermediate theplunger 622 and a distal end 626 of the damper 612.

Still referring to FIG. 18A, the distal end 626 may have at least oneinlet orifice 628 and at least one outlet orifice 630. The inlet orifice628 may have a check valve 632 which permits air to flow into the barrel620 while restricting air to flow out of the barrel 620 through thatorifice. The check valve 632 may pivot in the direction indicated byarrow 633. In one embodiment, the outlet orifice 630 is an open apertureallowing free flow of air (or other fluid) in and out of the barrel 620.The inlet orifice 628 and the outlet orifice 630 may have differentcross sectional areas, with the outlet orifice 630 being smaller thanthe inlet orifice 630. In some embodiments, the area of the outletorifice 630 is variable. The distal end 626 may also have a centerorifice 634 which is sized to accommodate the axially moveable member606. In various embodiments, a o-ring 636, or other sealing device, maybe used to maintain a seal between the distal end 626 of the damper 612and the axially moveable member 606. The barrel 620 and the distalsurface of the plunger 622 define a variable volume cavity 642. Thevolume of the variable volume cavity 642 decreases as the plunger 622 isdistally translated and increases in volume as the plunger 622 isproximally translated.

Referring again to FIGS. 18-21, the operation of the electrosurgicalinstrument 600 in accordance with one non-limiting embodiment will nowbe described. In FIG. 18 the electrosurgical instrument 600 isconfigured to begin the operational stroke. The plunger 622 ispositioned at the proximal end of the barrel 620 and the jaws of the endeffector 610 are in an open position. FIG. 19 illustrates theelectrosurgical instrument 600 as the trigger 607 is rotated (orsqueezed) in the direction indicated by arrow 650. As the trigger 607 isrotated, the plunger 622 is translated in the direction indicated byarrow 652. The biasing force of the spring 624 is overcome and thevariable volume cavity 642 is reduced in the volume. Air is expelledfrom the variable volume cavity via the outlet port 630 (FIG. 18A). Dueto the operation of the check valve 632, air is not expelled, orsubstantially expelled, through the inlet port 628 (FIG. 18A). Thus,when the user actuates the trigger 607, the speed of the axiallymoveable member 606 is controlled by the cross sectional area of theoutlet port 630. The expelling of air (or other fluid) from the variablevolume cavity 642 acts as a resistive force to the rotation of thetrigger 607 to slow the operational stroke of the axially moveablemember 606. As the plunger 622 translates within the barrel 620 theaxially moveable member 606 is distally translated and the end effector610 closes its jaws to capture and transect tissue therebetween with acutting element 607. As the plunger 622 distally translates within thebarrel 620, the spring 624 is compressed to create a stored energy whichbiases the end effector 610 open at the end of the cycle.

As shown in FIG. 20, the axially moveable member 606 may continue todistally translate to move the plunger 622 toward the distal end 626 ofthe barrel 620. The spring 624 is compressed between the plunger 622 andthe distal end 626 of the barrel 620. As is to be appreciated, energymay be introduced into the captured tissue to sufficiently weld thetissue prior to and during the operational stroke. As illustrated inFIG. 21, rotation of the trigger 607 in the direction indicated by arrow654 translates the plunger 622 in the direction indicated by arrow 656(e.g., proximally). As the plunger 622 is translated proximally, thevolume of the variable volume cavity 642 is increased. The increase involume generates a low pressure which draws air (or other fluid) intothe variable volume cavity 642. Due to the operation of the check valve632 (FIG. 18A), air is permitted to enter the variable volume cavity 642through both the inlet port 628 and the outlet port 630. Therefore, theplunger 622 may translate proximally with less resistance as compared todistal translation.

FIGS. 22-25 illustrates the electrosurgical instrument 600 with a damper660 having two check valves. The spring 624 is positioned external tothe damper 660 such that it provides a biasing force to the trigger 607.FIG. 22A is an enlarged cross-sectional view of the damper 660. Thedamper 660 comprises a barrel 662 which receives the plunger 622. Avariable volume cavity 664 is formed between the plunger 622 and thedistal end 666 of the barrel 662. The damper 660 further has a firstorifice 668 and a second orifice 670 positioned in the distal end 666 ofthe barrel 662. A first check valve 672 is positioned proximate thefirst orifice 668 and a second check valve 674 is positioned proximatethe second orifice 670. The first check valve 672 defines a first outlet676 and the second check valve 674 defines a second outlet 678. When theplunger 622 is translated in the distal direction, air is forced fromthe variable volume cavity 664 through the first outlet 676 and thesecond outlet 678. When the plunger 622 is translated in the proximaldirection, the check valves 672, 674 open and air is drawn into thevariable volume cavity 664 through the first orifice 668 and the secondorifice 670. The total cross-sectional area of the first and secondorifices 668, 670 may be greater than the total cross-sectional area ofthe first and second outlets 676, 678.

A damper may be coupled to the trigger and/or axially moveable member ofan electrosurgical instrument using any suitable configuration. FIG. 26illustrates an embodiment of a damper 680 that is coupled to a tab 682of the trigger 607 via a shaft 686. The damper 680 comprises a barrel688 that may have an inlet port 681 and outlet port 683 arrangementsimilar to the configuration illustrated in FIG. 18A. As is to beappreciated, however, any suitable configuration of orifices may beused. The shaft 686 is coupled to a plunger 684. In some embodiments,the shaft 686 and/or the plunger 684 may be integral with the trigger607. Rotation of the trigger 607 in the direction indicated by arrow 650drives the plunger 684 into the barrel 688. As the plunger 684 drivesinto the barrel 688, the volume of a variable volume cavity 690 insidethe barrel 688 is reduced. Fluid inside the variable volume cavity 690is expelled through outlet port 683. Thus, the damper 680 regulates thetranslation of axially moveable member 606 by providing resistance tothe trigger 607 when the user attempts to squeeze the trigger too fast.FIG. 26A is an illustration of the damper 680 in accordance with anothernon-limiting embodiment. A sealing member 694 (e.g., an o-ring) mayestablish a seal between the shaft 686 and an orifice 695 of the barrel688. The barrel 688 may be filled with a highly viscous fluid 692. Theplunger 684 may separate the barrel 688 into a first cavity 691 and asecond cavity 693. As the plunger 684 is translated within the barrel688, one of the cavities increases in volume while the other cavitydecreases in volume. The highly viscous fluid 692 may flow between thetwo cavities via a gap 696 between the plunger 684 and the inner wall ofthe barrel 688. In some embodiments, the plunger 684 may have orificesthat fluidly couple the first cavity 691 to the second cavity 693.During the operational stroke, the plunger 684 is translated in thebarrel 688 and the highly viscous fluid 692 generally opposes the motionof the plunger 684 to ultimately regulate the translation of the axiallymoveable member.

As is to be appreciated, any type of damper may be used. As illustratedin FIG. 27, in some embodiments, a rotary damper 700 may be used toregulate the movement of an axially moveable member 702. The rotarydamper 700 may comprise a sealed volume 704. In one embodiment, thesealed volume 704 is a cavity formed within a trigger 706. The triggermay be rotatable about a pivot 708. At least one fin 710 may be fixedwith respect to the trigger 706. As illustrated, the fins 710 mayradiate from the pivot 708. While two fins 710 are illustrated in FIG.27, it is to be appreciated that any number of fins 710 may be used.Furthermore, the fins 710 may be straight, curved, or a combination ofstraight and curved sections. In some embodiments, the fins may beattached to inner surface of the 712 of the sealed volume 704 and extendtoward the pivot 708. In any event, the sealed volume 704 may be filledwith a fluid 714, such as a highly viscous silicone fluid, for example.Protrusions 713 may extend into the sealed volume 704 and move relativewith respect to the fins 710 during rotation of the trigger 706. Theprotrusions 713 may be any size or shape. As the trigger 706 is rotatedin the direction indicated by arrow 716, the interaction of the viscousfluid 714, the fins 710, and the protrusions 713 will provide aresistive force to slow the rotation of the trigger. FIG. 27A is across-sectional view of the damper 700 taken along line 27A-27A. Thedamper 700 is rotatable about a central axis 701. While the fins 710 areillustrated in FIG. 27A as being generally rectangular, it is to beappreciated that any suitable shape may be used. Furthermore, the fins710 and/or protrusions 713 may be solid, as illustrated, or may bediscontinuous (e.g., vented or perforated) to achieve the desired fluidflow during rotation of the damper 700.

Referring again to FIG. 27, a return spring 720, or other biasingelement, may be coupled to the trigger 706 and the handle 722 in orderto urge the trigger 706 to its starting position after it is moved inthe direction indicated by arrow 724. During an operational stroke, theamount of counter force the trigger 706 experiences, (e.g., thedampening effect) will depend at least partially on the size of a gap718 between the pivot 708 and protrusions 713. As with the other dampersdescribed herein, the faster the trigger 706 is rotated, the higher theresistive force supplied by the rotary damper 700 will be. In otherwords, the resistive force may be proportional to the velocity of thetrigger actuation. If the user actuates the trigger 706 in a slow andcontrolled manner, the rotary damper 700 will provide relatively littleresistive force. If, however, the user actuates the trigger 706aggressively, the rotary damper 700 will provide a higher resistiveforce to slow the trigger actuation 716.

As is to be appreciated, any suitable type of damper may be used toregulate the stroke of the trigger. For example, in some embodiments,the damper may comprise a magnetorheological fluid damper or a solenoidhaving a variable resistance.

In some embodiments, other techniques may be used to regulate thetranslation of the axially moveable member. FIG. 28 illustrates anelectrosurgical instrument 800 incorporating an electromagnetic brakeassembly 802 in accordance with one non-limiting embodiment. Theelectrosurgical instrument 800 may have an end effector (notillustrated) similar to the end effector 110 illustrated in FIG. 3coupled to the distal end of an elongate shaft 804. An axially moveablemember 806 may extend from the distal end of the elongate shaft 804 intothe handle 808. A trigger 810 is coupled to the axially moveable member806. In one embodiment, the trigger 810 comprises a toothed section 812and the axially moveable member 806 comprises a rack 814. The toothedsection 812 of the trigger 810 is engaged to the rack 814 such thatrotational movement of the trigger 810 about a pivot 816 is transferredinto distal and proximal linear movement of the axially moveable member806. The rack 814 may have two general sections 818, 820. During anoperational stroke, the toothed section 812 first engages a firstsection 818 and the end effector captures and clamps tissue between twojaws, for example. As a second section 820 of the rack 814 engages thetoothed section 812, a cutting element may be driven through thecaptured tissue as described in greater detail below. Theelectromagnetic brake assembly 802 may regulate the stroke of themoveable cutting element 806 when the second section 820 of the rack 814is engaged to the toothed section 812. By regulating this portion of thestroke, the likelihood of advancing the moveable cutting element 806 tooquickly (e.g., before the captured tissue has been sufficiently welded)is reduced. Some embodiments may comprise other implementations ofelectrically actuated brake assemblies. For example, the brake assemblymay comprise an element that responds to external electrical stimulationby displaying a significant shape or size displacement, such as anelectroactive polymer (EAP), for example. In some embodiments, the brakeassembly may comprise a other components, such as a solenoid, amagnetorheological fluid damper, a reed relay, and/or a stepper motor,for example. All such embodiments are intended to be included in thisdisclosure.

FIG. 29 is an illustration of the electromagnetic brake assembly 802 inaccordance with one non-limiting embodiment. The electromagnetic brakeassembly 802 may comprise a collar 830. When a controller 832 suppliescurrent from a power source 834 a magnetic field around the collar 830is generated. The axially moveable member 806 is positioned proximatethe collar 830 and is has a ferrous component, for example, that isattracted to or repulsed by magnetic fields. The controller 832 mayreceive information via an input 836 to determine if a magnetic fieldshould be generated and/or the strength of the magnetic field. The input836 may be an indication of tissue temperature, tissue impedance, ortime, for example. In one embodiment, if the captured tissue has notreached suitable temperature to sufficiently weld tissue, theelectromagnetic brake 802 may be activated. Specifically, a magneticfield may be generated to attract the axially moveable member 806 to thecollar 830. When the axially moveable member 806 is attracted to thecollar 830, the distal progression of the axially moveable member 806 ishalted or slowed depending on the intensity of the magnetic fieldgenerated. Once the temperature of the captured tissue has reached asufficient level, the magnetic field of the collar 830 may be reduced oreliminated to allow the axially moveable member 806 to continue itsdistal translation.

As is to be appreciated, while the collar 830 is illustrated as having aringed cross-sectional shape, any suitable cross-sectional shape may beused. For example, the collar 830 may have a rectangular, triangular,trapezoidal, or other closed-form shape. In some embodiments, multiplecollars 830 having the same or different shapes may be used. Thisdisclosure is not limited to any particular size, shape, or arrangementof the collar(s) 830. FIG. 30 is an illustration of an electromagneticbrake assembly 840 in accordance with another non-limiting embodiment.In this embodiment, a brake element 842 is positioned proximate thetrigger 810. When the brake element 842 is energized by the controller832 a magnetic field is generated which attracts the trigger 810.Similar to the collar 830 illustrated in FIG. 29, the brake element 842may serve to regulate to movement of axially moveable member 806 byselectively engaging the trigger 810. When the trigger 810 is attractedto the brake element 842, the distal progression of the axially moveablemember 806 is halted or slowed depending on the intensity of themagnetic field generated.

FIG. 31 is a partial cut-away view of an electrosurgical instrument 900having an electromagnetic brake assembly in accordance with onenon-limiting embodiment. A partial cross-section is provided toillustrate an electromagnetic brake assembly 902. For the sake ofclarity, various components have been omitted from the electrosurgicalinstrument 900. The electrosurgical instrument 900 may have an endeffector (not illustrated) similar to the end effector 110 illustratedin FIG. 3 coupled to the distal end of an elongate shaft 904. An axiallymoveable member 906 may extend from the distal end of the elongate shaft904 into the handle 908. A trigger 910 is coupled to the axiallymoveable member 906. In one embodiment, the trigger 910 comprises apivot 912. A surface 914 of the trigger 910 may comprise a series oftrigger ridges 916. In one embodiment, the trigger ridges 916 radiateoutward from the pivot 912. The trigger ridges 916 are dimensioned toengage a brake pad 918. FIG. 32 illustrates an enlarged view of thebrake pad 918. The brake pad 918 may comprise pad ridges 920 withtroughs 922 positioned intermediate adjacent pad ridges 920. The troughs922 are dimensioned to receive the trigger ridges 916.

Referring again to FIG. 31, the brake pad 918 may be coupled to anelectromagnetic solenoid 924, or other component capable of selectablytranslating the brake pad 918 between a disengaged position and anengaged position (e.g., an electroactive polymer actuator). The solenoid924 may be energized by a controller 832 (FIG. 30). When the solenoid924 is activated, the brake pad 918 is driven toward the trigger ridges916 such that they engage with the pad ridges 920. When the ridges 916,920 are engaged, the trigger 910 is locked and may not be furtherrotated by the user. When the solenoid 924 is de-activated, the brakepad 918 is retracted and the trigger ridges 916 disengage from the padridges 920 to allow the trigger 910 to continue its rotation. Duringoperation, the user may simply apply pressure to the trigger 910 and theelectromagnetic brake assembly 902 will continually lock and un-lock thetrigger 910 in order to regulate the stroke. Similar to the embodimentsillustrated in FIGS. 29 and 30, a controller may use information fromvarious inputs to determine if the trigger 910 should be locked orunlocked. As is to be appreciated, the trigger ridges 916 and the brakepad 918 may be made from any suitable material or polymer, such as athermal set rigid plastic, for example. In some embodiments, the polymeris a nylon or rubber polymer, for example. In other embodiments, thetrigger ridges 916 and the brake pad 918 are made from a metal alloy,such as medical grade stainless steel, for example.

FIGS. 33A and 33B, illustrate the electromagnetic brake assembly 902 invarious stages of operation. The brake pad 918 is coupled to a padhousing 926 that is coupled to the solenoid 924. While the ridges 916,920 are illustrated in a saw tooth configuration, it is appreciated thatany suitable type of ridge shapes may be implemented. As illustrated,the operation of the solenoid may be controlled by a controller 932. Thecontroller 932 may receive information from a sensor 934. Theinformation may be, for example, tissue temperature information ortissue impedance information. In FIG. 33A, the brake pad 918 isseparated (i.e., disengaged) from the trigger ridges 916 of the trigger910. In this position, the trigger 910 may rotate with respect to thebrake pad 918. In FIG. 33B, the solenoid 924 has translated the brakepad 918 in the direction indicated by arrow 930. In this position, thebrake pad 918 is engaged to the trigger ridges 916 of the trigger 910 toinhibit the rotation of the trigger 910 with respect to the brake pad918. This position may be maintained until any number of conditions aresatisfied, such as a tissue temperature condition or a time-basedcondition. In at least one embodiment, the brake pad 918 can lock thetrigger 910 in position until the temperature and/or impedance of thetissue being treated has exceeded a certain temperature and/orimpedance. In such an embodiment, the advancement of movable member 906,and cutting member associated therewith, can be delayed until asufficient quantity of energy has been supplied to the tissue, asindicated by the sensed temperature and/or impedance. In suchcircumstances, the tissue may not be incised until the tissue hasreceived a minimum amount of energy. In some embodiments, the brake canbe operated on a time delay, i.e., an amount of time between the initialapplication of energy to the tissue and the release of the brake.

FIG. 34 is a partial cut-away view of an electrosurgical instrumenthaving an electromagnetic brake assembly 902 in accordance with onenon-limiting embodiment. As illustrated, the trigger ridges 916 arepositioned around a periphery of the trigger 910. The brake pad 918 ispositioned to engage the trigger ridges 916 when the brake pad 918 ismoved toward the trigger 910 by the solenoid 924. The brake pad 918 mayhave a curved portion 920 to mate with the periphery of the trigger 910.As is to be appreciated, while FIG. 31 and FIG. 34 illustrate twoembodiments of the brake pad 918, the present disclosure is not limitedto any particular brake pad configuration.

FIG. 35 illustrates an electrosurgical instrument 1000 havingelectromagnetic gates to regulate the operational stroke. Theelectrosurgical instrument 1000 may have an end effector 1010 similar tothe end effector 110 illustrated in FIG. 3 that is coupled to the distalend of an elongate shaft 1004. An axially moveable member 1006 mayextend from the distal end of the elongate shaft 1004 into a handle1002. A trigger 1007 is coupled to the axially moveable member 1006. Inone embodiment, the trigger 1007 comprises a trigger web 1008 that isreceived by the handle 1002 during a trigger stroke. The electrosurgicalinstrument 1000 may be electrically coupled to an electrical source1045. The electrical source 1045 may be connected to the electrosurgicalinstrument 1000 via a suitable transmission medium such as a cable 1052.In one embodiment, the electrical source 1045 is coupled to a controller1046.

The electrosurgical instrument 1000 may comprise an electromagnetengaging surface 1014 positioned proximate the trigger 1007 in thehandle 1002. In various embodiments, the electromagnet engaging surface1014 may be ferrous. The electrosurgical instrument 1000 may alsocomprise a plurality of electromagnetic gates 1012 positioned proximateto the trigger 1007. In one embodiment, the plurality of electromagneticgates 1012 are coupled to the trigger web 1008 such that they passproximate the electromagnet engaging surface 1014 during a triggerstroke. The electromagnetic gates 1012 may be selectively magnetized andde-magnetized by the controller 1046 in order to control the triggeractuation during the operational stroke.

FIGS. 36A-C are enlarged side views of the trigger web 1008 and theelectromagnet engaging surface 1014 during an operational stroke inaccordance with one non-limiting embodiment. As illustrated in FIG. 36A,electromagnetic gates 1012 a-c are coupled to the trigger web 1008 andare in electrical communication with the controller 1046 via signallines. In one embodiment, at the start of an operational stroke, all ofthe electromagnetic gates 1012 a-c are energized such that they create acorresponding magnetic field. The electromagnet engaging surface 1014 isattracted to the magnetic field of first electromagnetic gate 1012 a.The trigger 1007 will remain in this position until the firstelectromagnetic gate 1012 a is deactivated. Once the firstelectromagnetic gate 1012 a is deactivated, the user may actuate thetrigger 1007 to move the trigger 1007 in the direction indicated byarrow 1016. The electromagnet engaging surface 1014 will then beattracted to the magnetic field of the second electromagnetic gate 1012b (FIG. 36B). The trigger 1007 will remain in this position until thesecond electromagnetic gate 1012 b is deactivated. Once the secondelectromagnetic gate 1012 b is deactivated, the user may actuate thetrigger 1007 to move the trigger 1007 in the direction indicated byarrow 1016. The electromagnet engaging surface 1014 will then beattracted to the magnetic field of the third electromagnetic gate 1012 c(FIG. 36C). The trigger 1007 will remain in this position until thethird electromagnetic gate 1012 c is deactivated. Once the thirdelectromagnetic gate 1012 c is deactivated, the user may actuate thetrigger 1007 to move the trigger 1007 in the direction indicated byarrow 1016 to complete the operational stroke, if the operational strokehas not yet been completed.

While FIGS. 36A-C illustrate three electromagnetic gates 1012 a-c, it isto be appreciated that any number of electromagnetic gates may be used.For example, in some embodiments, two electromagnetic gates may be used,while in other embodiments, thirty electromagnetic gates may be used,for example. Additionally, similar to embodiments illustrated in FIG.33A-B, various sensors 934 may supply information to the controller 1046which is used to determine which electromagnetic gates to activate ordeactivate. Such information may include, for example, tissuetemperature information, tissue impedance information, or time delayinformation. Furthermore, in some embodiments, the electromagnetengaging surface 1014 may be coupled to the trigger 1007 and theelectromagnetic gates 1012 may be coupled to the handle 1002. In eitherevent, the advancement of the axially moveable member 1006 can bestaggered such that the axially moveable member 1006 can be movedincrementally in the distal direction. In at least one such embodiment,the movement of the axially movable member 1006, and a cutting memberassociated therewith, can be delayed until a significant amount ofenergy has been applied to the tissue being treated. In somecircumstances, the tissue may not be incised until the tissue hasreceived a minimum amount of energy. In certain circumstances, the ratein which the axially movable member 1006 may be moved distally may beimpeded, or slowed, until a certain amount of energy has been applied,and/or a certain temperature or impedance of the tissue has beenreached, wherein, thereafter the axially movable member 1006 may bepermitted to move distally at a faster rate or at a rate which isunimpeded by the gates. Thus, in certain embodiments, the trigger may besequentially held at every gate for the same amount of time while, inother embodiments, the trigger may be held at different gates fordifferent amounts of time.

In various embodiments, feedback signals may be provided to the userduring the operational stroke of the electrosurgical instrument. FIG. 37is a cut-away view of an electrosurgical instrument 1100 having afeedback indicator 1102 in accordance with one non-limiting embodiment.For the sake of clarity, various components have been omitted from theelectrosurgical instrument 1100. The electrosurgical instrument 1100 mayhave an end effector (not illustrated) similar to the end effector 110illustrated in FIG. 3 coupled to the distal end of an elongate shaft1104. An axially moveable member 1106 may extend from the distal end ofthe elongate shaft 1104 into the handle 1108. A trigger 1110 is coupledto axially moveable member 1106.

The trigger 1110 may be a ratcheting trigger that has multiple positionsalong the operational stroke. As illustrated, the trigger 1110 maycomprise a hub 1164 that rotates about a pivot 1166 during anoperational stroke. The hub may define a plurality of notches or detents1168 that rotate past a pawl 1160 during an operational stroke. The pawl1160 may be biased toward the hub by a spring 1162. The pawl 1160 maycomprise, for example, a ball bearing to engage the individual detents1168, for example. The number of detents 1168 may correspond to thenumber of discrete trigger positions along the operational stroke. Thedetents 1168 may be evenly spaced around the periphery of the hub 1168or the distance separating adjacent detents may vary. When the useractuates the trigger, the engagement of the pawl 1160 with the detent1168 provides tactile feedback to the user. The discrete positions maybe implemented using a pawl and ratchet, or any other suitabletechnique. In one embodiment, the trigger has at five positions (e.g.,five detents), for example, although any suitable number of positionsmay be used.

Still referring to FIG. 37, in a first position 1112, the trigger 1110is un-actuated and the jaws on the end effector are open and capable ofgrasping tissue. At a second position 1114, the axially moveable member1106 is distally advanced to close the jaws of the end effector. At thispoint in the operational stroke, energy may be applied to the capturedtissue. At a third position 1116, the axially moveable member 1106 hasstarted to transect the captured tissue. At a fourth position 1118, theaxially moveable member 1106 has continued to travel through thecaptured tissue and at the fifth position 1120 the tissue has beencompletely transected. As is to be appreciated, various embodiments theoperational stroke may have more or less discrete positions, asdetermined by the number of detents 1168.

The feedback indicator 1102 is configured to convey operationalinformation to the user. In one embodiment, the feedback indicator 1102is a series of lights (e.g., light emitting diodes). In one embodiment,the feedback indicator 1102 is positioned proximate the trigger 1110 andprovides a vibratory signal to the hand of the user. In one embodiment,the feedback indicator 1102 is a sound-emitting device that providedaudio signals to the user. In one embodiment, the feedback indicator1102 is a combination of multiple forms of feedback, such as a tactileand audio, for example. In one embodiment, the feedback indicator 1102is located in a position remote from the electrosurgical device 1100,such as on an external power supply, for example. For illustrationpurposes only, the operation of the feedback indicator 1102 will bedescribed in the context of a series of lights mounted on the handle1108 of the electrosurgical instrument 1100.

FIGS. 38A-D illustrate the progression of feedback signals provided bythe feedback indicator 1102 in accordance with one non-limitingembodiment. The feedback indicator comprises a first indicator 1131, asecond indicator 1132, a third indicator 1133, and a fourth indicator1134. In one embodiment indicators, 1131-1134 are light emitting diodes(LEDs) which may be toggled between a green indication and a redindication during the operational stroke. In some embodiments, the LEDsmay be white LEDs that are toggled between an on and an off state duringan operational stroke. In other embodiments, other forms of visualindicators may be used, such as an LCD screen, for example. Asillustrated in FIG. 33A, the feedback indicator 1102 may be electricallycoupled to a controller 1140. The controller 1140 may receiveinformation from a sensor 1148, such as a tissue impedance sensor. Thecontroller 1140 may comprise one or more processors 1142 and one or morecomputer memories 1146. For convenience, only one processor 1142 andonly one memory 1146 are shown in FIG. 38A. The processor 1142 may beimplemented as an integrated circuit (IC) having one or multiple cores.The memory 1146 may comprise volatile and/or non-volatile memory units.Volatile memory units may comprise random access memory (RAM), forexample. Non-volatile memory units may comprise read only memory (ROM),for example, as well as mechanical non-volatile memory systems, such as,for example, a hard disk drive, an optical disk drive, etc. The RAMand/or ROM memory units may be implemented as discrete memory ICs, forexample.

The feedback indicator 1102 may provide information to the user duringvarious stages in the operational stroke. For example, it may provideinformation to the user which helps the user control the pacing of theoperational stroke to increase the likelihood that an adequate tissueseal has been created. In one embodiment, the feedback indicator 1102provides feedback when the jaws are closed and the axially moveablemember is about to transect the captured tissue (e.g., the secondposition 1114). The movement of the trigger 1110 into the secondposition can be detected by the controller. Upon detecting the change inthe position, the controller may illuminate the first indicator 1131.When the first indicator 1131 is illuminated, the user may apply energyto the captured tissue. For example, the user may depress a button 1150(FIG. 37) positioned on the trigger 1110. The sensor 1148 may monitor acharacteristic or property the captured tissue, such as impedance, andwhen the tissue has reached a certain impedance level, the secondindicator 1132 may be illuminated, as illustrated in FIG. 38B. When theuser sees the second indicator 1132 illuminate (or otherwise toggle itsstate), the user may actuate the trigger 1110 to the next position(e.g., the third position 1116) to begin the cutting stroke. The sensor1148 may continue monitor the characteristic or property the capturedtissue, such as impedance, for example, and when the tissue has reacheda certain impedance level, the third indicator 1133 may be illuminated,as illustrated in FIG. 38C. When the user sees the third indicator 1133illuminate (or otherwise toggle its state), the user may actuate thetrigger 1110 to the next position (e.g., the fourth position 1118) tocontinue its cutting stroke. The sensor 1148 may continue monitor thecharacteristic or property the captured tissue, such as impedance, forexample, and when the tissue has reached a certain impedance level, thefourth indicator 1134 may be illuminated, as illustrated in FIG. 38D.When the user sees the fourth indicator 1134 illuminate (or otherwisetoggle its state), the user may actuate the trigger 1110 to the nextposition (e.g., the fifth position 1120) to complete its cutting stroke.

The embodiments of the devices described herein may be introduced insidea patient using minimally invasive or open surgical techniques. In someinstances it may be advantageous to introduce the devices inside thepatient using a combination of minimally invasive and open surgicaltechniques. Minimally invasive techniques may provide more accurate andeffective access to the treatment region for diagnostic and treatmentprocedures. To reach internal treatment regions within the patient, thedevices described herein may be inserted through natural openings of thebody such as the mouth, anus, and/or vagina, for example. Minimallyinvasive procedures performed by the introduction of various medicaldevices into the patient through a natural opening of the patient areknown in the art as NOTES™ procedures. Some portions of the devices maybe introduced to the tissue treatment region percutaneously or throughsmall—keyhole—incisions.

Endoscopic minimally invasive surgical and diagnostic medical proceduresare used to evaluate and treat internal organs by inserting a small tubeinto the body. The endoscope may have a rigid or a flexible tube. Aflexible endoscope may be introduced either through a natural bodyopening (e.g., mouth, anus, and/or vagina) or via a trocar through arelatively small—keyhole—incision incisions (usually 0.5-1.5 cm). Theendoscope can be used to observe surface conditions of internal organs,including abnormal or diseased tissue such as lesions and other surfaceconditions and capture images for visual inspection and photography. Theendoscope may be adapted and configured with working channels forintroducing medical instruments to the treatment region for takingbiopsies, retrieving foreign objects, and/or performing surgicalprocedures.

The devices disclosed herein may be designed to be disposed of after asingle use, or they may be designed to be used multiple times. In eithercase, however, the device may be reconditioned for reuse after at leastone use. Reconditioning may include a combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicemay be disassembled, and any number of particular pieces or parts of thedevice may be selectively replaced or removed in any combination. Uponcleaning and/or replacement of particular parts, the device may bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Those ofordinary skill in the art will appreciate that the reconditioning of adevice may utilize a variety of different techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of thisapplication.

Preferably, the various embodiments of the devices described herein willbe processed before surgery. First, a new or used instrument is obtainedand if necessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK® bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility. Other sterilization techniques can be done by anynumber of ways known to those skilled in the art including beta or gammaradiation, ethylene oxide, and/or steam.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.For example, different types of end effectors may be employed. Also,where materials are disclosed for certain components, other materialsmay be used. The foregoing description and following claims are intendedto cover all such modification and variations.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. An electrosurgical instrument, comprising: ahandle; an elongate shaft extending distally from the handle; an endeffector coupled to a distal end of the elongate shaft, comprising: afirst jaw member; a second jaw member, wherein the first jaw member ismoveable relative to the second jaw member between an open and a closedposition; a tissue-cutting element configured to translate with respectto the first jaw member and the second jaw member; and an electrode; anaxially moveable cutting member configured to move the first jaw memberto the closed position, the tissue-cutting element positioned at adistal end of the axially moveable cutting member, wherein thetissue-cutting element is configured to cut tissue captured by the endeffector; a trigger coupled to the axially moveable cutting member,wherein the trigger is moveable through a first range of motion toadvance the axially moveable cutting member to move the first jaw memberto the closed position, and wherein the trigger is moveable through asecond range of motion to advance the axially moveable cutting member totranslate the tissue-cutting element to cut the captured tissue; and apowered linear actuator coupled to the axially moveable cutting member,wherein the axially moveable cutting member is manually advanced withoutthe powered linear actuator to move the first jaw member to the closedposition during the first range of motion of the trigger, and whereinthe axially moveable cutting member is advanced with the powered linearactuator to translate the tissue-cutting element to cut the capturedtissue during the second range of motion of the trigger.
 2. Theelectrosurgical instrument of claim 1, wherein the powered linearactuator comprises a motor and a lead screw.
 3. The electrosurgicalinstrument of claim 2, comprising a nut assembly in threaded engagementwith the lead screw.
 4. The electrosurgical instrument of claim 1,wherein the powered linear actuator distally drives the axially moveablecutting member in the second range of motion of the trigger.
 5. Theelectrosurgical instrument of claim 4, wherein the first jaw membermoves from the open position to the closed position in the first rangeof motion of the trigger.
 6. The electrosurgical instrument of claim 1,further comprising: a force transducer coupled to the axially moveablecutting member; and a linear actuator controller in electricalcommunication with the powered linear actuator and the force transducer.7. The electrosurgical instrument of claim 6, wherein the linearactuator controller is configured to drive the powered linear actuatorat an adjustable speed.
 8. The electrosurgical instrument of claim 7,wherein the linear actuator controller is configured to determine theadjustable speed based at least on a signal from the force transducer.9. The electrosurgical instrument of claim 1, further comprising: apressure sensor coupled to the trigger; and a linear actuator controllerin electrical communication with the powered linear actuator and thepressure sensor, wherein the linear actuator controller is configured todrive the powered linear actuator at an adjustable speed, wherein thelinear actuator controller is configured to determine the adjustablespeed based at least on a signal from the pressure sensor.
 10. Theelectrosurgical instrument of claim 9, further comprising an electricalinput; and a switch moveable between an unactuated position and anactuated position, wherein the electrical input is electrically coupledto the electrode when the switch is in the actuated position.
 11. Theelectrosurgical instrument of claim 10, further comprising a triggersensor, wherein the trigger sensor supplies a trigger signal to thelinear actuator controller in the second range of motion of the trigger.12. The electrosurgical instrument of claim 11, wherein the linearactuator controller actuates the powered linear actuator when the switchis in the actuated position and the trigger sensor supplies the triggersignal.
 13. An electrosurgical instrument, comprising: a handle; anelongate shaft extending distally from the handle, an end effectorcoupled to a distal end of the elongate shaft, comprising: a first jawmember; a second jaw member, wherein the first jaw member is moveablerelative to the second jaw member between an open and a closed position;a tissue-cutting element configured to translate with respect to thefirst jaw member and the second jaw member; and an electrode; an axiallymoveable cutting member configured to move the first jaw member to theclosed position, the tissue-cutting element positioned at a distal endof the axially moveable cutting member, wherein the axially moveablecutting member comprises a distal stop and a proximate stop, and whereinthe tissue-cutting element is configured to cut tissue captured by theend effector; a trigger coupled to the axially moveable cutting membermoveable between a first position, a second position, and a thirdposition, wherein the trigger is moveable from the first position to thesecond position to advance the axially moveable cutting member to movethe first jaw member to the closed position, and wherein the trigger ismoveable from the second position to the third position to advance theaxially moveable cutting member to translate the tissue-cutting elementto cut the captured tissue; and a powered linear actuator coupled to anut, wherein the nut is coupled to the axially moveable cutting memberintermediate the distal stop and the proximate stop, wherein the triggeris configured to manually advance the proximate stop towards the nutwithout the powered linear actuator as the trigger moves from the firstposition to the second position, and wherein the trigger is configuredto advance the nut away from the proximate stop with the powered linearactuator as the trigger is moved from the second position to the thirdposition.
 14. The electrosurgical instrument of claim 13, wherein theproximate stop engages the nut when the trigger is in the secondposition.
 15. The electrosurgical instrument of claim 13, wherein thepowered linear actuator comprises a lead screw in threaded engagementwith the nut.
 16. The electrosurgical instrument of claim 13, whereinthe powered linear actuator distally drives the axially moveable cuttingmember when the trigger moves from the second position to the thirdposition.
 17. The electrosurgical instrument of claim 13, furthercomprising: an electrical input; and a switch moveable between anunactuated position and an actuated position, wherein the electricalinput is electrically coupled to the electrode when the switch is in theactuated position.
 18. The electrosurgical instrument of claim 17,wherein the powered linear actuator distally drives the axially moveablecutting member when the switch is in the actuated position and thetrigger is in the third position.
 19. An electrosurgical instrument,comprising: a handle; an elongate shaft extending distally from thehandle; an end effector coupled to a distal end of the elongate shaft,comprising: a first jaw member, a second jaw member, wherein the firstjaw member is moveable relative to the second jaw member between an openand a closed position; a tissue-cutting element configured to translatewith respect to the first jaw member and the second jaw member; and anelectrode; an axially moveable cutting member configured to move thefirst jaw member to the closed position, the tissue-cutting elementpositioned at a distal end of the axially moveable cutting member; atrigger coupled to the axially moveable cutting member, wherein thetrigger is moveable between a first position and a second position toadvance the axially moveable cutting member to sequentially move thefirst jaw member to the closed position and cut tissue captured by theend effector; a motor coupled to the axially moveable cutting member; aload cell coupled to the axially moveable cutting member; wherein theload cell is configured to output a load signal; and wherein the motordistally drives the axially moveable cutting member at a variable speed,wherein the variable speed is at least partially based on the loadsignal, wherein the trigger is configured to advance the axiallymoveable cutting member without the motor to move the first jaw memberto the closed position, and wherein the trigger is configured to advancethe axially moveable cutting member with the motor to cut the capturedtissue.